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Friday, February 11, 2011

Dayton VA Dental Clinic Malfeasance

DARRELL HAMPTONNovember 2, 2010To Whom This May Concern:Approximately 45-60 days ago the Dayton VA shut down the Dental Clinic in an emergency. It appeared that a dentist named Dr. Dwight Pemberton, 82 years old, had infected several Veterans with blood born pathogens.Over the past 2 years several dental staff employees had reported, on multiple occasions, to the Chief of Medicine, Stephen Cohen, as well as the Medical Center Director, Guy Richardson, that Dr. Pemberton was practicing in violation of standard sanitary protocols. Neither executive moved to correct this problem. Now, what was swept under the rug has become a huge lump.They closed the Dental Clinic, started transferring Vets to Cincinnati or Columbus for treatment and begun a search of exactly how many Vets Dr. Pemberton had treated. The number was staggering. It seems he has treated over 2000 (two-thousand) Veterans. They have set aside a section of the Medical Center for triage and will began to send letters to each and every Veteran treated by this 82 year old Dentist and start testing for blood born pathogens. They are testing for HIV, Hep C, Hep B and MYRSA. They have worked very diligently to keep this out of the MSM.As a person whose reputation has been to expose VA violations in their treatment of America’s Veterans I am continuing in that effort.If you have any questions and/or concerns as to the veracity of this story please feel free to contact me.I have been writing of the apathy and downright disrespect towards the Honorably Discharged Veterans emanating from Guy B. Richardson. My last meeting with him, when I mentioned that Veterans were arriving for appointments hungry and leaving in the same condition, he replied: “ I am not here to feed hungry Veterans”! This was an incredible demonstration of arrogance on his part! Sincerely Yours,Darrell Hampton

Infection control among workers is focus of VA dental clinic investigationThe Dayton VA Medical Center closed its dental clinic for three weeks late this summer as part of an ongoing investigation into whether employees were following infection control practices.No evidence has been uncovered to date indicating any veterans have been infected, said Dr. George Arana, acting assistant deputy undersecretary for health operations and clinical management for the Department of Veterans Affairs in Washington, D.C.It wasn’t immediately clear how many of the clinic’s 12 to 14 employees might not have been adhering to infection control standards. The alleged inappropriate practices may have been going on for years, perhaps even decades, Arana said.The temporary closing resulted in the cancellation of 657 patient appointments. Those patients with more immediate dental needs were referred to VA clinics in Cincinnati, Columbus or Chillicothe, officials said.An employee raised concerns about infection control practices at the Dayton VA dental clinic while an internal VA panel was reviewing clinic operations in late July. VA officials closed the clinic Aug. 19 and reopened it Sept. 10.“We wanted to be assured that patients were in a safe environment,” Dayton VA Director Guy Richardson said.The allegations involved improper use of protective gear such as gloves, as well as the inappropriate use of burs — rotary cutting instruments used in dentistry for excavating decay, shaping cavity forms, reducing tooth structure, and adjusting or removing prostheses or dentures.The allegations did not involve needles, which comprise the major risk for transmitting bloodborne pathogens, officials said.Patient volumes have returned to normal levels, VA officials said. Spokesman Todd Sledge said the clinic’s staffing levels have not changed significantly since the incident. The clinic has seven dentists.The investigation should be complete in one to three months, Arana said.Sledge said he’s not aware of any disciplinary action so far related to the incident, though discipline could be forthcoming.VA officials said they announced the investigation in the interest of transparency and accountability.Patients with concerns may call a toll-free VA number: 1 (877) 424-8214.VA to test 535 dental patients for infections At least 535 veterans will be offered free screenings to see if they were infected with Hepatitis B, Hepatitis C or HIV at the Dayton VA Medical Center’s dental clinic between 1992 and July 2010. The VA on Tuesday began contacting veterans seen by a dentist who failed to change latex gloves between appointments. The dentist, whose identity was not disclosed, also did not sterilize burs properly— rotary cutting instruments used in dentistry for excavating decay, shaping cavity forms, reducing tooth structure, and adjusting or removing prostheses or dentures. The unidentified dentist is still employed at the VA, but hasn’t seen patients since July 28. Any veterans found to be infected will receive treatment at no cost, though the risk of blood-borne infection is thought to be “extremely low,” said Dr. George Arana, acting assistant deputy undersecretary for health operations/clinical management for the Department of Veterans Affairs. The Dayton VA will set up a dental communication center, staffed around the clock, as well as a dental special care clinic open from 8 a.m. to 6 p.m. Monday through Friday, and 8:30 a.m. to 4:30 p.m. Saturday at Building 320 (Lakeside Manor) at the Dayton VA, 4100 W. Third St. For an appointment, veterans should call (877) 424-8214. Dayton VA Director Guy Richardson could not say Tuesday what the cost of the VA’s response to the infection control problems would be. He had no answer for how the infection control issue went unaddressed for 18 years, noting internal reviews did not detect the problem. The number of veterans at risk for infection could grow, officials said. Contact this reporter at (937) 225-7457 or bsutherly@DaytonDailyNews.comVA dental clinic’s temporary closing causes backlogSince he had his 13 remaining teeth pulled Sept. 10, Larry Vernovage of West Alexandria has waited five months to be fitted for dentures at the Dayton VA Medical Center’s dental clinic.“Overall, I have no complaints with the VA,” said Vernovage, 64, who described the medical care he’s received at the medical center as some of the best he’s had in his life. But he called the delays he’s experienced at the dental clinic “ridiculous.”“A guy almost has to get shot in the mouth to get in there in the first place,” Vernovage said.Guy Richardson, the Dayton VA’s director, acknowledged the dental clinic has been working through a backlog of patients since it closed for three weeks during late summer 2010 to address infection control issues.The VA said Tuesday it will offer testing to more than 500 veterans to ensure they did not contract Hepatitis B, Hepatitis C or HIV. Those veterans had been seen between 1992 and July 2008 by a dentist who did not change his Latex gloves or sterilize tools between patients.There has been subsequent turnover of the dental clinic’s staff, with both a full-time clinician and part-time clinician retiring since late summer, Richardson said.The dentist who was the focal point of the VA’s recent investigation into infection control practices remains on the VA’s payroll, but has not seen patients since July 28.The dental clinic saw 3,142 veterans and had 11,400 visits during federal fiscal year 2010 (Oct. 1, 2009 - Sept. 30, 2010).The Dayton VA will face no financial penalties, but has implemented a “dental infection control dashboard” to heighten infection control surveillance and randomly review its clinicians’ competencies and credentials, Richardson saidBy Updated 11:41 PM Wednesday, February 9, 2011 DAYTON — At least one former supervisor at the Dayton VA Medical Center’s dental clinic took little action after learning a dentist often reused dental equipment on patients without sterilizing it first, according to testimony obtained Wednesday by the Dayton Daily News. The dentist’s performance had been an issue for years. When told the dentist’s actions likely exposed veterans to blood-borne pathogens, a former dental service chief told investigators the dentist “was not trainable. He wouldn’t take direction. And given the circumstances — that I had not really any avenue to get him out of the service — there wasn’t a lot I felt I could do at the time.” A 42-page Dayton VA investigation report shows several dental clinic employees knew for years a dentist was not following proper hygiene practices. “I’ve seen him literally walk from his room with this patient’s denture in one hand, go across to another room, open this patient’s mouth with this denture of the opposite patient in his hand,” one dental assistant told investigators. “I’ve seen him use the same instruments, the same handpiece, the same burs all day long on every patient. I’ve seen him go out of the clinic and push the button on the elevators with dirty gloves on. I’ve seen him open lab doors with dirty gloves on; I’ve seen him go in the lunchroom and use the microwave with dirty gloves on.” The dentist “repudiated” investigators’ claims against him, according to the report. He remains on the VA’s payroll, but has not seen patients since July 28. Administrative action against him is pending. The report also: Expressed concern about the dentist’s cognitive status, saying that during his interview, the dentist often became confused, gave conflicting statements, and did not appear to understand fully the gravity of the situation. One person’s testimony suggested the dentist is elderly, though the Dayton VA declined to disclose his age. Alluded to testimony indicating the dentist spent “a good deal of clinic duty time conducting genealogy studies” on his work computer. Found dental students were permitted to practice without the required level of supervision, and staff dentists entered themselves as the primary provider of care that was in fact provided by unlicensed students. Found evaluations of professional staff were “wholly insufficient” and represented a “gross failure of leadership.” Exonerated Dayton VA Medical Center Director Guy Richardson, saying he had no knowledge of the dentist’s conduct. The Dayton VA did not immediately respond to a request for comment on the report, which was provided to the Dayton Daily News on Wednesday. An employee raised concerns about infection control practices at the Dayton VA dental clinic while an internal VA panel was reviewing clinic operations in late July. VA officials closed the clinic Aug. 19 and reopened it Sept. 10. The VA said Tuesday it would test at least 535 veterans to see if they may have contracted Hepatitis B, Hepatitis C or HIV as a result of the poor infection control. It has set up a dental communication center, staffed around the clock, as well as a dental special care clinic open from 8 a.m. to 6 p.m. Monday through Friday, and 8:30 a.m. to 4:30 p.m. Saturday at Building 320 (Lakeside Manor) at the Dayton VA, 4100 W. Third St. For an appointment, veterans should call (877) 424-8214. The Dayton VA on Tuesday began contacting at least 535 veterans, offering them free screenings to see if they were infected with Hepatitis B, Hepatitis C or HIV between 1992 and July 2010 due to the dentist’s poor infection-control practices. The testing is expected to cost $18,000 to $25,000, VA spokesman Todd Sledge said.

1 comment:

In this morning’s Dayton Daily News Paper a detailed report of the investigation of the Dayton VA Dental Clinic is being reported. http://www.daytondailynews.com/news/dayton-news/va-dental-service-chief-aware-dentist-failed-to-sterilize-tools-1077574.html CNN is also running this story. It claims that the Medical Center Director, Guy B. Richardson had no knowledge of the plethora of violations committed by this dentist, Dwight M. Pemberton, who at 81 years old was still being allowed to practice on America’s Veterans and paid over $3000 a week to expose Veterans to blood born pathogens.

I find this information wanting.

Every morning at the Dayton VA the very first thing that happens is the “Morning Report” where Service Chiefs and their assistants meet with the Director to discuss any urgent or pending issues. For Mr. Guy Richardson to expect America’s Veterans to believe that he held these meetings daily for over five years (over 1400 meetings) and he was not made aware of what was happening in this instance is a disrespect of our intellect. I make the charge that he is lying sir and I do not make this charge lightly. He is lying to the Veterans, he is lying to the American people and he is lying to you Sir.

This Dentist was so negligent that most VA employees warned Veterans not to be seen by him. The entire dental staff talked about his malfeasance regularly. In fact, according to this newspaper report virtually everybody at the Dayton VA knew about this “except” Guy Richardson. His stunning ignorance is proof that he is unfit to lead this facility.

I have written your office on many occasions that Mr. Richardson is apathetic to the service that America’s Veterans receive. His arrogant statement to me, when I reported that Veterans come to the VA for appointments hungry and leave in the same condition, “I’m not here to feed hungry Veterans” displayed an example of indifference I have not witnessed in many individuals.

Mr. Richardson is either lying or he is too incompetent to lead. Whatever the case, he should be removed from leadership at this Medical Center. I will be making this identical recommendation to members of the US Senate Veterans Service Committee.

About Me

Honorably Dischrged, after 3 years of "voluntary service" US Army Veteran during the Viet Nam conflict. I did not go to combat. I was 17 years old, 5'9" tall and I weighed 109 lbs. I was Gung ho and itching to fight for my country...My 1st Sgt and Captain had better sense and sent me to Germany! Thank God!